Long-term biocompatibility of a miniature stimulator implanted in feline hind limb muscles

Chronic foreign-body responses and muscular changes were examined following the implantation of active miniature stimulators into the hind limb muscles of cats for periods of up to three months. The radio-frequency (RF)-powered stimulators were injected into muscles through a 12-gauge hypodermic needle. The tissue responses around the active stimulators were compared histologically to those provoked by passive devices, broken glass, silicone tubing, polyester suture material coated with polybutylate, and two of the internal components of the stimulator (ferrite, integrated circuit chip). Active and passive stimulators produced similar, benign foreign-body reactions that resulted in an essentially identical fibrous capsule over time. The responses were similar to those produced by the internal components and the suture material, and were more modest than those produced by the broken glass. The capsule did not appear to interfere with the functionality of active devices because thresholds measured during the post-implantation survival period did not change significantly over time. Unexpectedly, the severity of the reaction differed significantly amongst the various target muscles. Medial gastrocnemius exhibited the most severe response, whereas tibialis anterior had the least reaction.

Feline caudofemoralis muscle. Muscle fibre properties, architecture, and motor innervation

Feline caudofemoralis (CF) is a promising preparation in which to study the properties of mammalian fast-twitch skeletal muscle, but little is known about its muscle fiber properties, architecture, and motor innervation. We used histochemical techniques to confirm that it contained predominantly type IIB fibers (95+/-2%, n=8, with six of eight muscles composed exclusively of type IIA and IIB fibers), but physiological experiments showed less fatiguability than for the type IIB component of medial gastrocnemius. This may be related to the surprisingly strong and regular recruitment of CF during repetitive tasks such as walking and trotting, which we demonstrated electromyographically. We measured muscle length over the anatomical range of motion for CF (approximately 0.6-1.2 L0) and estimated working length during walking and trotting (approximately 0.95-1.15 L0). The specific tension was similar to that of the exclusively slow-twitch soleus muscle (31.2+/-4.7 N/cm2 compared with 31.8+/-4.1 N/cm2; P>0.8). Single fiber dissections of CF revealed a series-fibered architecture with a mean of 2.3 fibers, each 2.5 cm long, required to span the fascicle length. We identified two neuromuscular compartments in CF by cutting one of the two nerve branches innervating CF and depleting the glycogen stores in the intact motor units. These compartments were in parallel and extended the length of the muscle; their electromyographic activity was similar during various natural behaviors. CF and gluteus maximus motoneurons were labeled concurrently with a combination of fluorescent, retrograde tracers including Fluororuby, Fluorogold and Fast Blue. The CF motor nucleus was located in L7-S1, overlapping and intermingling extensively with the nucleus of the adjacent gluteus maximus muscle. Distributions of CF motoneuron diameter revealed one large peak around 50-55 microm, with relatively few small-diameter (less than 35 microm) cells. Using estimates of the total number of fibers in three muscles and the estimated number of alpha-motoneurons for those same muscles, we calculated a mean innervation ratio of approximately 270, which is at the low end of the innervation ratios for type IIB motor units from other feline muscles and more similar to type IIA motor units. In general, CF appears to be a useful preparation in which to study the properties of fast-twitch muscle, but these properties may vary somewhat from type IIB fibers from different muscles.

The effect of sarcomere length on triad location in intact feline caudofeomoralis muscle fibres

The location of triads within a mammalian skeletal muscle sarcomere has traditionally been defined as 'at the A-I junction'. We attempted to verify this statement by examining systematically the location of triads within the sarcomere over the physiological range of sarcomere lengths. This study was conducted using intact feline muscle fibres from caudofemoralis and exclusively fast-twitch muscle from the hindlimb. Our results intact fibres indicate that the distance between the Z-band and triad (ZT) is relatively constant over the range of sarcomere lengths (SLs)examined in this study (1.8-3.4 micron). The slope between ZT and SL was measured to be 0.06 +/- 0.01 (r= 0.36, p < 0.001) while the slope between the M-line to triad distance (MT) and SL was measured to be 0.44 +/- 0.01 (r > 0.9, p < 0.001). The mean ZT was 0.52 +/- 0.07 micron, which corresponds to a triad location approximately halfway along the thin filaments. These results do not support the traditional statement regarding triad location. Nor do these results support a similar recent study conducted using chemically skinned muscle fibres from rat extensor digitorum longus (also a homogeneously fast-twitch muscle of the hindlimb), in which a slope of 0.25 was observed between ZT and SL (r > 0.9, p < 0.01). These results are, however, in qualitative agreement with results using intact fibres from fast-twitch rat semitendinosus. Based upon known morphology, we suggest that the only structure supporting triad position is the SR itself, and that a non-homogeneous distribution of the SR within the sarcomere might be responsible for maintaining triad location near the mid-region of the thin filaments. We also suggest that there might be optimal design reasons for locating the triads at the mid-region of the thin filaments.

Design for an inexpensive but effective cochlear implant

Widespread application of cochlear implants is limited by cost, especially in developing countries. In this article we present a design for a low-cost but effective cochlear implant system. The system includes a speech processor, four pairs of transmitting and receiving coils, and an electrode array with four monopolar electrodes. All implanted components are passive, reducing to a minimum the complexity of manufacture and allowing high reliability. A four-channel continuous interleaved sampling strategy is used for the speech processor. The processor and transmission link have been evaluated in tests with a subject previously implanted with the Ineraid electrode array and percutaneous connector. A prototype of the link, consisting of four pairs of transmitting and external receiving coils, was used, with the outputs of the receiving coils directed to four intracochlear electrodes through the percutaneous connector. The subject achieved speech reception scores with the prototype system that were equivalent to those achieved with a standard laboratory implementation of a continuous interleaved sampling processor with current-controlled stimuli.

Speech-processing strategies designed for children

The design of cochlear prosthetic hardware and speech-processing strategies has been driven largely by psychophysical data from postlingually deafened adults with implants. In such subjects, success is related to the ability of the electrical stimulation to evoke the same patterns of neural activity and hence the same percepts as were produced formerly by acoustic input. Adults differ greatly in their ability to make use of information provided through electrical stimulation, particularly as temporal patterns. Recent research suggests that the manner in which information is processed in the auditory nervous system can be influenced by the type of information that is available during development of hearing. Because cochlear prostheses are used increasingly in prelingually deaf children, we must face the difficult task of designing and testing speech-processing strategies that are more appropriate for developing nervous systems whose first and only experience with sound comes from electrical stimulation.

Micromodular implants to provide electrical stimulation of paralyzed muscles and limbs

We describe the design, fabrication, and output capabilities of a microminiature electrical stimulator that can be injected in or near nerves and muscles. Each single-channel microstimulator consists of a cylindrical glass capsule with hermetically sealed electrodes in either end (2-mm diameter x 13-mm overall length). Power and digital control data can be transmitted to multiple implants (256 unique addresses) via a 2-MHz RF field created by an external AM oscillator and inductive coil. In vitro testing demonstrated accurate control of output pulsewidth (3-258 microseconds in 1-microseconds steps) and current (0-30 mA in two linear ranges of 16 steps each, up to 8.5 V available compliance voltage). Microstimulators were used successfully for chronic stimulation in hindlimb muscles of cats. Design and fabrication issues affecting yield and reliability of the packaging and electronics are discussed.

Relationships between range of motion, lo, and passive force in five strap-like muscles of the feline hind limb

The relationships between range of motion, optimal length for force production (lo), and passive force provide useful insights into the structure and function of muscles but are unknown for most individual muscles. We measured these values and examined their relationships in five strap-like muscles of the cat hind limb: caudofemoralis, semitendinosus, sartorius anterior, tenuissimus, and biceps femoris anterior. The range of motion relative to lo was found to vary significantly between different muscles and even between different specimens of the same muscle. The passive force-length (FL) curve was found to be correlated with both lo and lmax (maximal in situ muscle length) but was correlated more strongly with lmax. The mean passive force produced by these muscles at lmax was less than 7% of estimated maximal isometric force, suggesting that passive force may not be important in these muscles during normal activation patterns. The variance in passive FL curves between specimens of the same muscle was found to be significantly lower when length was scaled by lmax as opposed to lo. These results suggest that lmax may provide a more useful scaling factor for generic models of muscle. However, the passive length-tension properties of mammalian muscle appear to reflect a complex mix of structures at both the myofilament and connective tissue levels that may differ depending on muscle-fiber architecture and perhaps on the history of trophic influences on a particular specimen.

Effect of neck posture on patterns of activation of feline neck muscles during horizontal rotation

The electromyographic (EMG) patterns of neck muscles were recorded during whole-body horizontal rotation in head-free, alert cats and head-restrained, decerebrate cats. In some trials the cervical column of the animal was oriented vertically, whereas in others it was oriented more horizontally. In alert cats making head movements that compensated for the motion of the platform, neck muscles with modulated patterns of activity could be divided into a subset whose individual EMG patterns changed significantly when the neck posture was altered (including longissimus capitis, obliquus capitis superior and scalenus anterior) and a subset whose individual EMG patterns were invariant regardless of neck posture (including obliquus capitis inferior, levator scapulae and complexus). In head-restrained, decerebrate cats, electromyograms from all implanted muscles were modulated similarly in phase with the platform position. Changing the orientation of the neck had little effect upon these EMG patterns evoked by the horizontal vestibulocollic reflex. One decerebrate cat with strong extensor tone was tested further under head-free conditions. There was very little compensatory head movement, but individual neck muscles displayed patterns of activity that were more similar to those observed in alert, head-free animals.

Mechanics of feline soleus: I. Effect of fascicle length and velocity on force output

The aim of the present study was to quantify how fascicle length and velocity modify force production in cat soleus. A computerized muscle puller controlled the length and velocity of the whole-muscle. We recorded the force output at the tendon and the length of muscle fascicles using sonomicrometry during whole-muscle isometric and isokinetic contractions. Peak muscle stress was estimated as 31.8 +/- 4.1 N cm-2 (mean and SD) and optimal fascicle length, Lo, was estimated as 3.8 +/- 0.6 cm which corresponds to an optimal sarcomere length of 2.49 +/- 0.08 microns. The isometric force-length data followed closely the expected force-length relationship for cat sarcomeres. The force-velocity relationship was found to be similar in shape between cats, but the per cent increment of force over isometric levels for lengthening contractions was highly variable. Estimates of the kinematics of the fascicles based on whole-muscle length were systematically incorrect; whole-muscle velocity was 21% greater than fascicle velocity. The force-velocity data demonstrated consistent dependencies on fascicle length. At lengths below 0.7 Lo (1.74 microns), the shape of the force-velocity relationship was altered by the inclusion of a passive, repulsive force in the estimate of active isometric force. The shape of the force-velocity relationship changed at lengths greater than 0.7 Lo, but was restricted to lengthening velocities where the increment of force with respect to isometric levels was found to increase with fascicle length. This change in shape in the force-velocity relationship for lengthening contractions reveals a systematic, but previously unknown interdependence between fascicle length and velocity on muscle force production.

Mechanics of feline soleus: II. Design and validation of a mathematical model

We have developed a mathematical model to describe force production in cat soleus during steady-state activation over a range of fascicle lengths and velocities. The model was based primarily upon a three element design by Zajac but also considered the many different features present in other previously described models. We compared quantitatively the usefulness of these features and putative relationships to account for a set of force and length data from cat soleus wholemuscle described in a companion paper. Among the novel features that proved useful were the inclusion of a short-length passive force resisting compression, a new normalisation constant for connective-tissue lengths to replace the potentially troublesome slack length, and a new length dependent term for lengthening velocities in the force-velocity relationship. Each feature of this model was chosen to provide the most accurate description of the data possible without adding unneeded complexity. Previously described functions were compared with novel functions to determine the best description of the experimental data for each of the elements in the model.

Neural signals for command control and feedback in functional neuromuscular stimulation: a review

In current functional neuromuscular stimulation systems (FNS), control and feedback signals are usually provided by external sensors and switches, which pose problems such as donning and calibration time, cosmesis, and mechanical vulnerability. Artificial sensors are difficult to build and are insufficiently biocompatible and reliable for implantation. With the advent of methods for electrical interfacing with nerves and muscles, natural sensors are being considered as an alternative source of feedback and command signals for FNS. Decision making methods for higher level control can perform equally well with natural or artificial sensors. Recording nerve cuff electrodes have been developed and tested in animals and demonstrated to be feasible in humans for control of dorsiflexion in foot-drop and grasp in quadriplegia. Electromyographic signals, being one thousand times larger than electroneurograms, are easier to measure but have not been able to provide reliable indicators (e.g., of muscle fatigue) that would be useful in FNS systems. Animal studies have shown that information about the shape and movement of arm trajectories can be extracted from brain cortical activity, suggesting that FNS may ultimately be directly controllable from the central nervous system.

Cuff electrodes for chronic stimulation and recording of peripheral nerve activity

A comparative study of 5 different designs of nerve cuff electrodes was undertaken to determine their relative merits for stimulating and recording whole-nerve activity over extended periods of chronic implantation on large and small peripheral nerves in 8 cats. Four of the designs represent novel fabrication strategies, including 2 based on flexible, thin-film substrates and 2 based on dip-coating silicone elastomer on a cylindrical mandrel. Various advantages and shortcomings of these materials and designs are discussed in the context of the biophysical factors that influence these electrophysiological interfaces, particularly the problem of recording microvolt-level neurograms in the presence of millivolt-level electromyograms from adjacent muscles in freely behaving subjects. The most effective design was one in which a thin sheath of silicone rubber was wrapped around and intra-operatively sealed to a longitudinally slit, tripolar cuff made by dip-coating silicone over stranded stainless steel leads that were prepositioned on a mandrel using polyvinyl alcohol as a temporary adhesive. When properly installed, these electrodes had stable impedances, recruitment thresholds and relatively interference-free recording properties for the duration of this study (up to 9 weeks).

Microminiature molding techniques for cochlear electrode arrays

We provide a general method for producing a variety of small, complex electrode arrays based on injection molds produced using computer-aided drafting and machining (CAD-CAM) procedures and a novel method for connecting to the very fine electrical leads associated with the individual contacts of such arrays. Cat-sized cochlear electrode arrays with up to eight contacts were built according to these methods and their electrical contacts were characterized in vitro by impedance spectroscopy and in vivo by monitoring impedance for over 1 year of intermittent stimulation in chronically instrumented animals.

Toward the ultimate metal microelectrode

The performance of metal microelectrodes for stimulating and recording neuronal action potentials depends on precise control of their geometrical, electrical and mechanical properties. We describe a combination of materials whose properties approach fundamental physical limitations on achievable performance and reproducible fabrication techniques that provide probes with very small dimensions. Pure iridium wire is electrolytically sharpened, vapor-coated with Parylene-C insulation and the tip exposed using an automatically steerable UV laser. Electrochemical activation of the iridium increases the capacitance of the metal-electrolyte interface so that the overall impedance in the relevant frequency band (100-10,000 Hz) is dominated by the access resistance of the surrounding tissues.

Influence of materials and geometry on fields produced by cochlear electrode arrays

Most cochlear prostheses use multichannel electrode arrays implanted in the scala tympani to generate multiple parallel channels of activity in the tonotopically mapped auditory nerve. Various materials and geometrical arrangements of contacts and locations within the scala tympani have been used, resulting in substantial differences in the required stimulus strengths and resulting spatial distributions of neural activity. Activated iridium (AIR) permits systematic adjustment of its metal-electrolyte interface properties by changing the degree of electrochemical activation. Planar equivalent models of bipolar cochlear electrode geometries using iridium have been built, and their impedance magnitude and phase versus frequency for various degrees of activation have been characterised. The electrical fields produced at various distances from bipolar contacts in saline are measured. In comparison to platinum and unactivated iridium, AIR provides a much lower metal-electrolyte interfacial impedance. When two AIR contacts are placed with their edges close together, the resulting field distributions are determined largely by the high (but safe) current densities at their apposed edges rather than the overall extent of the contacts. These edge effects permit a novel design for a bipolar array that produces N channels of radially distributed, non-overlapping fields and that requires only N + 1 contacts.

Mechanical properties of aponeurosis and tendon of the cat soleus muscle during whole-muscle isometric contractions

Recent studies have suggested that the mechanical properties of aponeurosis are not similar to the properties of external tendon. In the present study, the lengths of aponeurosis, tendon, and muscle fascicles were recorded individually, using piezoelectric crystals attached to the surface of each structure during isometric contractions in the cat soleus muscle. We used a surgical microscope to observe the surface of the aponeurosis, which revealed a confounding effect on measures of aponeurosis length due to sliding of a thin layer of epimysium over the proximal aponeurosis. After correcting for this artifact, the stiffness computed for aponeurosis was similar to tendon, with both increasing from around 8 F0/Lc (F0 is maximum isometric force and Lc is tissue length) at 0.1 F0 to 30 F0/Lc at forces greater than 0.4 F0. At low force levels only (0.1 F0), aponeurotic stiffness increased somewhat as fascicle length increased. There was a gradient in the thickness of the aponeurosis along its length: its thickness was minimal at the proximal end and maximal at the distal end, where it converged to form the external tendon. This gradient in thickness appeared to match the gradient in tension transmitted along this structure. We conclude that the specific mechanical properties of aponeurosis are similar to those of tendon.

The computation of position sense from spindles in mono- and multiarticular muscles

It is known that muscle spindles provide the majority of information about limb position, but little is known about how position sense is computed from their signals. We have developed a family of musculoskeletal models in order to determine some of the fundamental properties associated with transforming noisy spindle information into putative internal coordinate frames for position sense. A two-joint model was developed containing one biarticular and two monoarticular muscles with a total of 1000 sensors distributed among them. The sensors were assumed to function like spindle secondary afferents under fusimotor control designed to optimize their ability to encode static position in the presence of constant output noise. The optimal distribution of sensors was found to depend strongly on the coordinate frame in which position was measured (intersegmental angle, segment orientation, or end-point of the limb) and on the topology of the biarticular muscle with respect to the plane of motion. A similar analysis was performed for an anthropometric model of the human arm, using previously published counts of muscle spindles. In general, the actual distribution of spindles about the elbow and shoulder does not seem to favor any single coordinate frame for position sense. We also looked at the potential accuracy in detecting changes in joint angles based on the distribution of muscle spindles throughout the human body. The distribution of spindles about individual joints accounts well for psychophysical data showing a proximodistal descending gradient of angular resolution that partially reflects the relative importance of more proximal joints for determining the location of the end-point.

Effect of neck posture on the activation of feline neck muscles during voluntary head turns

1. To determine whether neck posture affects the usage of neck muscles during a specific motor task, we recorded the electromyographic (EMG) patterns of neck muscles in four cats, which made horizontal, head-turning movements to fixate eccentrically placed targets. In some trials, the cervical column was oriented vertically whereas in other trials, the cervical column was oriented more horizontally. 2. During horizontal head movements, five muscles (obliquus capitis inferior, splenius, levator scapulae, complexus, and biventer cervicis) displayed activation patterns that were consistent from cat to cat and did not change when the cats adopted a different neck posture. Most of these muscles are large, superficial muscles that attach to the skull and span many cervical joints. 3. Posturally dependent patterns of activation were observed in five other neck muscles (semispinalis cervicis, longissimus capitis, levator scapulae ventralis, scalenus anterior, and obliquus capitis superior). Most of these muscles lie deeper and more laterally within the neck musculature and generally span fewer cervical joints than the muscles that displayed invariant patterns of activation. 4. These results suggest that the set of invariantly activated muscles may compose part of a basic motor program that is triggered during head movements in the horizontal plane. This motor program appears to be modified by the selective activation of ancillary muscles, which are recruited in a manner related to the neck posture. The deep positioning of the ancillary muscles may permit them to regulate the mobility of the cervical column and to adjust the net muscular force applied across the neck to the skull. Organizing the motor output in this manner might simplify the task of computing the appropriate patterns of neck-muscle activation.

Facial input to neck motoneurons: trigemino-cervical reflexes in the conscious and anaesthetised cat

Cutaneous facial inputs influencing head movement were examined in the conscious and anaesthetised cat. EMG recordings were made in neck muscles of conscious, unrestrained cats in which an unexpected light cutaneous stimulus was applied to the glabrous skin of the planum nasale (PN). These observations established that head aversion movements were associated with synchronised activation of both deep and superficial dorsal neck muscles. In anaesthetised cats in which activity in the motoneurons of the large dorsal neck muscles was examined, mechanical stimulation of the PN or electrical stimulation of the infraorbital nerve (ION) produced a short latency, reflex activation. The reflex could be elicited by excitation of low threshold, rapidly conducting fibres in the ION. Intracellular recording from neck motoneurons showed that there is a short latency, probably disynaptic, excitatory pathway from low threshold nerves in the ION to neck motoneurons, but discharge of neck motoneurons occurred several milliseconds later, presumably as a result of activity in a longer multisynaptic pathway.

The distal hindlimb musculature of the cat: interanimal variability of locomotor activity and cutaneous reflexes

During stereotyped behaviors such as locomotion, patterns of muscle recruitment are usually quite consistent from animal to animal, even in the face of many surgical and pharmacological reductions. However, as studies of musculoskeletal structure, neuromuscular architecture, and sensorimotor circuitry become more detailed, it is important to ask whether there is some level of organization at which individual differences begin to dominate. This study concentrated on the small muscles of the foot and ankle, using standardized methods that consistently record stereotypical electromyographic activity from prime mover muscles and that permit well-calibrated stimulation of cutaneous nerves to elicit reflexes during treadmill locomotion. Some muscles (particularly the main ankle extensors, triceps surae, and plantaris) had stereotyped activity during both unperturbed locomotion and reflex responses. Others had stereotyped activity during locomotion but variable reflex patterns among animals (tibialis anterior, extensor digitorum longus, flexor hallucis longus, and peroneus brevis). Still others had variable locomotor activity but reflexes that were consistent (flexor digitorum longus) or variable for only peroneal nerve stimulation (peroneus longus), only plantar nerve stimulation (peroneus tertius), or the two (flexor digitorum brevis). Among muscles with interanimal variability, there seemed to be no particular correlation between locomotor and reflexive recruitment in a given animal. This functional heterogeneity is discussed in terms of the development of locomotor and reflex programs and in the context of structural heterogeneity of some of these muscles that is described in the companion paper.

The distal hindlimb musculature of the cat: multiaxis moment arms at the ankle joint

The cat hindlimb muscles have been classified, traditionally, as flexors and extensors, based on their actions in the parasagittal plane and their patterns of recruitment during locomotion and reflex responses. This study provides a detailed examination of the relative magnitudes of the various moment arms of the cat ankle muscles and the interdependent effects of position in the various axes of motion. We used a method based on observing small sliding movements of tendon in response to small angular displacements of the joint. Surprisingly, we found that the ankle joint of the cat permits substantial motion in three axes (eversion/inversion and abduction/adduction as well as extension/flexion) and many muscles crossing the ankle joint have their largest moment arms about axes other than extension/flexion. These moment arms often depended on the joint position in the axis of the moment arm and, to a lesser degree, on the extension/flexion angle as well. For some muscles (notably peroneus longus) there was sufficient variability that the predominant action in neutral posture (axis with the largest moment arm) could change from animal to animal, which may be related to heterogeneities of locomotor and reflex recruitment reported in the companion paper.

Morphometry of human thigh muscles. Determination of fascicle architecture by magnetic resonance imaging

A previous investigation suggested that striation patterns spanning individual muscles in longitudinally oriented MR images may represent the orientation of its fascicles. In this study, we confirmed that these striation patterns could be used to infer fascicle orientation and to compute other architectural features of muscles from MR images. The volumes of 14 muscles within a cadaveric thigh were shown to be estimated accurately from cross-sectional MR images by comparison with direct measures from muscle mass. The angles of striations were measured at several positions within vastus medialis and semimembranosus from sagittal and frontal-plane MR images. Mathematical techniques were developed to infer the 3-dimensional orientation of fascicles based on these striation angles. The angle of striations in a 3rd oblique plane was shown to agree with mathematical predictions based on these computed orientations. The pennation angle, defined as the angle between the fascicles and the line of action of the muscle, predicted from the MR images, was similar to directly measured values. Interestingly, the pennation angle of these fascicles varied along the length of the muscle; in vastus medialis, pennation angle ranged from 5 degrees to 50 degrees in a proximodistal direction. Procedures were developed and validated to compute fascicle length by projection of fascicle orientation across the 3D shape of the muscles. The use of MR images to estimate muscle morphometry could improve greatly the predictive capabilities of musculoskeletal modelling by reducing the number of unknown model parameters.

Why cats pace on the treadmill

There have been many studies suggesting that locomotion on a treadmill tends to be different than locomotion at similar velocities overground, but no satisfactory mechanical or neural mechanisms to account for the differences have been identified. The most prominent difference is the tendency to adopt a pacing gait for both walking and trotting speeds, in which the legs on one side of the body move in phase as lateral couplets rather than the typical diagonal couplet pattern seen overground. Using conventional video analysis, we quantified the gait patterns of intact, adult cats walking at various speeds overground and in a motorized treadmill. We noted that cats paced most frequently when they were at the front end of the treadmill enclosure, and that this gait was associated with an extended stride length that permitted the animals to maintain a higher duty factor of support (mean number of feet on the ground). We propose that the animal extends its stride specifically to improve the duty factor in anticipation of sudden stops of the treadmill belt and that it converts abruptly from diagonal to lateral gait because the extended stride results in collisions between ipsilateral hind and front feet.

Effect of velocity and mechanical history on the forces of motor units in the cat medial gastrocnemius muscle

1. Two fundamental aspects of the dynamic behavior of motor units of the cat medial gastrocnemius (MG) muscle were measured. Force-velocity (FV) relationships were measured with the use of constant velocity shortening and lengthening movements. Effects of mechanical history were assessed via comparisons of forces immediately after or during slow movements with standard isometric forces. Isometric force-length (FL) relations were also measured, and the effect of different stimulation rates on both FV and FL data was assessed. 2. Prior or concurrent movement greatly potentiated motor-unit force, but this movement potentiation was highly dependent on the amplitude of the unit's force. The smallest twitch forces of type S units (< 10 mN) were potentiated more than threefold, but no potentiation occurred for unit forces > 200 mN. It was tentatively concluded that movement potentiation may play little role in normal movements because it does not occur at forces > 1% of maximal isometric force of the MG. 3. During shortening, the normalized FV relations of type S units were relatively steeper than those of type FR or FF units. For lengthening, there was no evident relation between FV steepness and motor-unit type. 4. Stimulation rate affected both the FV and FL relationships of the motor units. The peak of the FL relationship (Lo) clearly shifted to shorter muscle lengths as stimulation rate was increased. The steepness of the FV relationship for shortening was decreased by increasing stimulation rate, but this effect was modest. 5. The shift in motor-unit Lo and the differences in motor-unit FV relationships were hypothesized to play significant roles during normal motor behavior. Realistic computer simulations of FL and FV functions for a population of motor units undergoing normal steady-state recruitment and rate modulation supported these hypotheses. As the level of simulated neural drive increased, the population Lo shifted to considerably shorter lengths, and the normalized FV function became much less steep. The significance of these results for models of muscle are discussed.

An intrinsic mechanism to stabilize posture--joint-angle-dependent moment arms of the feline ankle muscles

The neuromuscular system can use sensory feedback to regulate motion, but these feedback loops involve relatively long delays (50-100 ms) and may produce undesirable oscillations. However, stabilizing changes in muscle force can also be provided intrinsically (i.e. without feedback) by 2 properties of the muscle itself, its force-length and force-velocity relationships. We have discovered another intrinsically stabilizing mechanism in the musculoskeletal architecture of the cat ankle joint. Many of its muscles have their predominant moment arms about the adduction/abduction axis, with smaller moment arms for inversion/eversion and about the principal axis of motion, dorsiflexion/extension. The magnitudes of the moment arms in ab/adduction and in/eversion depend strongly on joint angle, increasing for positions away from neutral that lengthen the muscles. Thus, co-activation of agonist-antagonist pairs, known to occur in these muscles, would provide immediate stabilizing changes in torque when the ankle is perturbed away from neutral position.

Neuromuscular organization of feline anterior sartorius: II. Intramuscular length changes and complex length-tension relationships during stimulation of individual nerve branches

The feline anterior sartorius is a long strap-like muscle composed of short muscle fibers. Nerve branches that enter this muscle contain the axons of motor units whose constituent muscle fibers are distributed asymmetrically within the muscle. In the present study, twitch and tetanic isometric contractions were evoked by stimulating individual nerve branches while muscle force was recorded and intramuscular length changes were monitored optically by the movement of reflective markers on the muscle. Contractions elicited by stimulating the parent nerve produced little change in the positions of the surface markers. Contractions elicited by stimulating the proximally or distally directed nerve branches caused the muscle to shorten at the end closest to the nerve branch and lengthen at the opposite end. Some muscles were supplied by a centrally directed nerve branch whose stimulation produced variable effects: in some cases a portion of the muscle shortened whereas the rest lengthened, but in other cases, the positions of the surface markers showed little change. The intramuscular length changes produced by stimulating single nerve branches were greater during isometric contractions at short whole-muscle lengths than at long whole-muscle lengths. The twitch and tetanic length-tension relationships obtained by stimulating the individual nerve branches were not congruent with the length-tension relationship produced when the parent nerve was stimulated. At short whole-muscle lengths, stimulation of a single nerve branch generated only a small fraction of the force that could be generated by the muscle when the parent nerve was stimulated. As whole-muscle length increased, an increased fraction of total muscle force could be generated by stimulating a single nerve branch. The results suggest that a complex relationship between passive and active elements contributes to the total muscle force and depends on the distribution of active and passive muscle units throughout the muscle.

Electromyographic studies of neck muscles in the intact cat. I. Patterns of recruitment underlying posture and movement during natural behaviors

Natural head movements in alert, unrestrained cats were studied using video-filming, videofluoroscopy and electromyographic (EMG) recording methods. In each cat, up to sixteen neck muscles or neck-muscle compartments were implanted with recording electrodes. Patterns of muscle recruitment were examined during systematically-selected behavioral epochs in which the cat held a range of stationary postures, and when it performed volitional and exploratory behaviors such as flexion-extension or turning, grooming, eating, or headshaking. Patterns of muscular activity were interpreted with reference to simultaneous video images of head and neck movements. In separate, videofluoroscopic analysis, flexion-extension movements were examined to gain insight into the underlying movements of the skull and cervical vertebrae. These and other movements were found commonly to depend upon changes in joint angles between lower as well as upper cervical joints. Stationary postures in which the neck was held vertically were consistently associated with tonic EMG activity in only two long dorsal muscles, biventer cervicis and occipitoscapularis. Less consistent activity was also present in dorsal intervertebral muscles crossing lower cervical joints. When the neck was held horizontally, the long dorsal muscles increased their EMG activity and moderate activity was also recorded in deeper intervertebral and suboccipital muscles. When flexion-extension occurred around upper cervical joints, greatest activity was recorded in rectus capitis posterior and complexus, but when it involved the lower cervical joints, large changes in EMG activity could also be detected in biventer cervicis, occipitoscapularis, and the intervertebral muscles crossing lower cervical joints. During specialized, sagittal-plane movements such as grooming, well-defined patterns of synergy could be recognized that varied according to the degree of involvement of upper and lower cervical joint-sets. Movements in the horizontal plane were associated with EMG activity in a largely different subset of neck muscles including splenius, longissimus capitis and obliquus capitis inferior. The levels of EMG activity during flexion-extension or turning movements were much lower than those observed during other more vigorous behaviors, such as head shaking. Some neck muscles, such as clavotrapezius and sternomastoideus, could only be recruited during forceful or ballistic head movements. Results showed that the patterns of muscular activation were linked not only to the speed and trajectory of the movements of the skull, but also to the kinematics of the motion occurring across different parts of the cervical column.

Electromyographic studies of neck muscles in the intact cat. II. Reflexes evoked by muscle nerve stimulation

Short-latency reflexes were studied in the neck muscles of four alert cats following electrical stimulation of nerves supplying biventer cervicis (BC), splenius (SP) or rectus capitis posterior (RCP). Reflexes were assessed by comparing levels of EMG activity of muscles before and after each stimulus, as the cats lapped milk, licked their paws or walked on a treadmill. When BC or SP nerves were stimulated at 1.5-4 times threshold (T) for their motor axons, no short-latency heteronymous reflexes could be identified in most neck muscles. However, stimulation of RCP nerves produced inhibitory effects as early as 3-4 ms in the ipsilateral BC, CM, and SP muscles and 6 ms in contralateral BC. At stimulus strengths above 4xT, a more complex pattern of inhibitory or excitatory effects was observed in CM, SP and the intervertebral muscle spinalis dorsi. The reflex effects were attenuated or abolished by partial or complete C1 dorsal rhizotomy (2 cats). Cervicocollic reflex data may need to be reevaluated to consider the possible effects of disinhibition rather than excitation in short-latency reflex pathways.

Injectable microstimulator for functional electrical stimulation

A family of digitally controlled devices is constructed for functional electrical stimulation in which each module is an hermetically sealed glass capsule that is small enough to be injected through the lumen of a hypodermic needle. The overall design and component characteristics of microstimulators that receive power and command signals by inductive coupling from a single, externally worn coil are described. Each device stores power between stimulus pulses by charging an electrolytic capacitor formed by its two electrodes, made of sintered, anodised tantalum and electrochemically activated iridium, respectively. Externally, a highly efficient class E amplifier provides power and digitally encoded command signals to control the amplitude, duration and timing of pulses from up to 256 such microstimulators.

Functionally complex muscles of the cat hindlimb. I. Patterns of activation across sartorius

The cat sartorius (SA) can be divided functionally into an anterior (SAa), knee extensor portion and a medial (SAm), knee flexor portion; it can be further subdivided anatomically by multiple nerve branches into parallel longitudinal columns that terminate in a distributed insertion at the knee with a continuous range of moment arms. Thus, SA may be controlled by a discrete number of motoneuron task groups reflecting a small number of central command signals or by a continuum of activation patterns associated with a continuum of moment arms. To resolve this question, the activation patterns across the width of the SA were recorded with an electrode array during three kinematically different movements--treadmill locomotion, scratching and paw shaking, in awake, unrestrained cats. Uniformity of activation along the longitudinal axis was also examined because individual muscle fibers do not extend the length of the SA. In addition, the cutaneous reflex responses were recorded throughout all regions of the SA during locomotion. Two fascial surface-patch arrays, each carrying 4-8 pairs of bipolar EMG electrodes, were sutured to the inner surface of the SA, one placed proximally and the other more distally. Each array sampled separate sites across the anterior to medial axis of SA. During locomotion, two basic EMG patterns were observed: the two burst-per-step-cycle pattern typical of SAa and the single burst pattern typical of SAm. There was an abrupt transition in the pattern of activation recorded in the two parts of SA during locomotion, and no continuum in the activation pattern was observed. Stimulation of both sural and saphenous cutaneous nerves during locomotion produced reflex responses that were uniformly distributed throughout SA, in contrast to the regional differences noted during unperturbed walking. Similarly, during scratching and paw shaking all parts of the SA were active simultaneously but with regional differences in EMG amplitude. The abrupt functional border between SAa and SAm coincided with the division of the SA into a knee flexor vs. a knee extensor. In all cases, the quantitative and qualitative differences in SAa and SAm EMGs were uniformly recorded throughout the entire extent of SAa or SAm; i.e., there was no segregation of activity within either SAa or SAm. Furthermore, the time course of EMG from each proximal recording site was nearly identical to the corresponding distal site, indicating no segregation of function along the longitudinal axis of SA. These results indicate that SAa and SAm constitute the smallest functional modules that can be recruited in SA.(ABSTRACT TRUNCATED AT 400 WORDS)

Functionally complex muscles of the cat hindlimb. V. The roles of histochemical fiber-type regionalization and mechanical heterogeneity in differential muscle activation

Several cat hindlimb muscles that exhibit differential activation (activity that is restricted to a specific region of muscle) during natural movements were studied to determine the possible roles of 1) non-uniform distribution of histochemically-identified muscle fiber-types (semitendinosus, ST; tibialis anterior, TA) or 2) mechanical heterogeneity (biceps femoris, BF; tensor fasciae latae, TFL). Using chronic recording techniques, electromyographic (EMG) activity was recorded from multiple sites of each muscle during treadmill locomotion, ear scratch, and paw shake. Standard histochemical analysis was performed on each muscle to determine fiber-type distribution. The histochemically regionalized muscles (ST and TA) were differentially active during slow locomotion; the deep regions (high in type I [SO] fibers) were active, but the superficial regions (high in type IIB [FG] fibers) were inactive. Vigorous movements (fast locomotion, ear scratch, paw shake) produced additional, synchronous activation of the superficial regions. In all movements, ST and TA activation patterns were consistent with the existence of identically timed synaptic inputs to all motoneurons within each motoneuron pool, resulting in an orderly recruitment of each whole pool. The differential activation recorded from ST and TA during slow locomotion was presumably a consequence of the non-uniform distribution of the different muscle fiber types. In contrast, differential activation of the histochemically nonregionalized, mechanically heterogeneous muscles (BF and TFL) resulted from non-synchronous activation of different muscle regions. The selective activation of BF or TFL compartments was indicative of differential synaptic inputs to, and selective recruitment of, subpopulations of the motoneuron pool, with each motoneuron subpopulation exclusively innervating physically separate regions of the muscle consistent with the regions defined by the neuromuscular territories of the major nerve branches supplying each muscle. Individual neuromuscular compartments of BF and TFL differ in their mechanical arrangements to the skeleton and in their contribution to mechanical action(s) at the hip and knee joints. Selective neural activation of mechanically distinct compartments within a mechanically heterogeneous muscle can provide highly advantageous mechanical "options" for animals that perform kinematically diverse movements. With regard to EMG recording techniques, the results of this study emphasize the need for carefully chosen EMG sampling sites and the value of knowing the muscle histochemistry, neuromuscular and musculoskeletal anatomy and possible mechanical functions prior to recording EMG.

Functionally complex muscles of the cat hindlimb. IV. Intramuscular distribution of movement command signals and cutaneous reflexes in broad, bifunctional thigh muscles

Similarities between the muscle synergies associated with the flexion reflex and locomotion in reduced preparations have suggested that spinal circuits subserving these two motor tasks might share common interneurons. To test this hypothesis in functionally complex muscles, we studied the interaction between low-threshold cutaneous afferents and the locomotor central pattern generator (CPG) during treadmill locomotion in awake, intact cats. Electrical stimuli were delivered via implanted nerve cuff electrodes at all phases of locomotion, and EMGs were recorded from fourteen intramuscular subregions in eight bifunctional thigh muscles (adductor femoris, biceps femoris, caudofemoralis, gracilis, semimembranosus, semitendinosus, tensor fasciae latae, and tenuissimus). In addition, the EMG patterns recorded during locomotion were compared with those recorded during two other centrally driven rhythmical behaviors, scratching and paw shaking, to determine whether the functional relationships among these intramuscular subregions were fixed or task dependent. Four of the five broad, bifunctional muscles studied (biceps femoris, gracilis, semimembranosus, and tensor fasciae latae) had functional subunits that could be differentially activated in one or more of the three movements studied; adductor femoris was consistently uniformly activated despite its distributed skeletal attachments. The pattern of recruitment of the intramuscular functional subunits was movement-specific. The locomotor CPG and cutaneous reflex pathways both similarly subdivided some bifunctional muscles, but not others, into intramuscular subregions. The results of the present study confirm that some combinations of muscle subregions and cutaneous nerves constitute simple reciprocal categories of flexors and extensors, as described originally by Sherrington (1910). "Typical" low threshold excitatory or inhibitory reflex responses were produced in muscles or muscle subregions that were recruited as "net" flexors of extensors, respectively. However, muscles with complex activation patterns during walking often had very individualized, complex reflex responses during locomotion that did not conform to the background locomotion synergies. All of the reflex responses observed were mediated by low threshold cutaneous afferents. These data indicate that there are multiple, low threshold, excitatory and inhibitory cutaneous reflex pathways that have highly specialized connections with flexor and extensor muscles and even their intramuscular subregions. It is also clear that the premotoneuronal circuits mediating these cutaneous reflex effects are not necessarily synonymous with those of the locomotor CPG. These two systems do interact powerfully, however, suggesting some convergence. The nature of the convergence between the CPG and the many independent subsets of spinal interneurons mediating cutaneous reflexes is specialized and muscle subregion-specific.

Morphometry of the human thigh muscles. A comparison between anatomical sections and computer tomographic and magnetic resonance images

The present study examined the relative accuracy and precision of MR and CT procedures for determining the CSA of individual muscles from the human thigh. Serial AN, CT and MR cross-sections were obtained from three cadaveric lower limbs. The MR measurements provided accurate and precise values for the CSAs of most thigh muscles, generally within +/- 7.5% of the AN standard. In contrast, CT tended systematically to overestimate the AN CSA by 10-20%. Retest procedures indicated that highly reliable measurements could be obtained from both MR and CT images. However, subjective interpretations of boundaries between closely apposed muscle bellies, particularly for muscles with more than one head, were necessary for resolving entities in the imaging records and this decreased the relative accuracy of MR and CT measures. Interestingly, MR records demonstrated an incomplete septum between vastus lateralis and vastus intermedius more prominently than AN cross-sections. The novel cross-validation procedures used in this study also highlighted several system-based errors in the MR records that, if undetected and left uncorrected, would have seriously biased the morphometric data obtained with this technique. In general, MR provides high resolution images of the human thigh muscles which may be used to obtain valid measures of the CSA of these structures.

Functionally complex muscles of the cat hindlimb. II. Mechanical and architectural heterogenity within the biceps femoris

The goal of this study was to analyze the architecture of the cat biceps femoris (BF), a multifunctional hamstring muscle, and to evaluate the relationships between muscle architecture, limb position, and muscle function during natural movement. The BF muscle consists of three neuromuscular compartments: anterior (BFa), middle (BFm) and posterior (BFp). Each compartment is innervated by a separate nerve branch. Nerve branch stimulation and 2-dimensional surface EMG recordings showed that individual compartment territories were discrete and non-overlapping with well-defined borders. Comparisons of the three compartments revealed consistent differences in architecture, relationship to the skeleton, and function. The BFa crossed only the hip joint and appears to function as a pure hip extensor. The BFm had equal lever arm lengths to the hip and knee joints, appears to function as a hip extensor, and may contribute to knee flexion or femoral rotation. The BFp had a greater lever arm to the knee, functions as a knee flexor, and may contribute to hip extension, femoral rotation or ankle extension. Measurements of individual fascicles from the three compartments revealed a surprising range of lengths, 3.3-12.0 cm. Microdissection of gold-stained tissue showed that fascicles from all compartments were comprised of interdigitated, short fibers (range: 0.6-5.0 cm; average 2.14 cm) arranged in-series in fascicles, running parallel to the origin-insertion axis of each muscle compartment. In regions of fiber interdigitation, the fiber endings were round and tapered (taper lengths: 1-11 mm) although flat, tapering endings like ribbons were occasionally found. As hip and knee joint angles were varied over physiological ranges corresponding to minimal to maximal muscle length, fascicles of the three compartments changed length disproportionately. Long BFa fascicles maximally lengthened 10-18%, consistent with in vivo length measures during treadmill locomotion. However, the long BFp fascicles lengthened 25-45%, and the relatively short fascicles near the BFm/BFp border maximally lengthened 45-53%. How do these unexpectedly large length changes affect sarcomere lengths? Using laser diffraction to measure sarcomeres, static fascicle and sarcomere lengths were compared in muscles that went into rigor mortis after fixing the hip and knee joint angles. Sarcomeres within the short BFm/BFp and long BFp fascicles consistently lengthened proportionately less than the whole fascicle. It remains to be determined how and where the fascicle length changes are dissipated in the connective tissue between the interdigitated muscle fibers and whether such a series-compliance operates during the large excursions over which this muscle normally works.

Distribution of motoneurons supplying cat sartorius and tensor fasciae latae, demonstrated by retrograde multiple-labelling methods

Sartorius (SART) and tensor fasciae latae (TFL) in the cat hindlimb are functionally heterogeneous muscles with regions that differ in their skeletal actions and electromyographic recruitment during normal activity. The topographical organization of motoneurons supplying different regions of SART or TFL has been investigated by exposing cut nerve branches supplying different peripheral territories to a combination of retrograde tracers, including Fast Blue (FB), Fluorogold (FG), and horseradish peroxidase (HRP). Motoneurons supplying medial, central, and anterior regions of SART were intermixed extensively throughout a single columnar nucleus located in the ventrolateral part of segments L4 and L5. With this column, motoneurons supplying medial SART tended to lie more rostrally than those supplying anterior regions, but the gradient was modest and showed some cat-to-cat variation. Two major branches entered anterior SART at different proximodistal levels. When these two branches were exposed to different tracers, most motoneurons contained a single tracer; only a few double-labelled cells were apparent. The labelling suggests that anterior SART may contain two separate, in-series divisions of motor units. In TFL, motoneurons supplying nerve branches to posterior, central, and anterior parts of the muscle were intermingled indiscriminately in a single ventrolateral cell column in L6 and rostral L7. These results suggest that topographical organization in lumbar motor nuclei does not always reflect the highly ordered biomechanical and functional specialization evident in the peripheral organization of the muscles themselves.

Issues in cochlear prosthetics from an international survey of opinions

Cochlear prostheses are beginning to be implanted regularly to restore hearing in profoundly deaf patients, but there is little agreement on the relative merits of the many different designs and rehabilitative procedures. We report on the responses to a technology assessment questionnaire that was sent to 120 researchers and clinicians worldwide who have been at the forefront of research in this field.

Monosynaptic and dorsal root reflexes during locomotion in normal and thalamic cats

1. In normal and thalamic walking cats electrical stimulation of muscle nerves via chronically implanted electrodes produced electromyographic (EMG) and neurographic responses that were modulated in amplitude depending on the phase of the step cycle. These responses were examined for possible indications of effects of primary afferent depolarization (PAD) during stepping. 2. Monosynaptic reflexes (MSRs) produced by stimulating the lateral gastrocnemius (LG) and medial gastrocnemius (MG) nerves were recorded as EMGs in MG or LG muscles during treadmill locomotion in normal cats. These heteronymous MSR responses were greatest during the stance (extensor) phase. 3. In the same animals, after decerebration, similar modulation of the heteronymous ankle extensor MSRs occurred during spontaneous locomotion with the use of the same stimulus and recording sites. 4. In both normal and thalamic cats the amplitude of neurogram responses recorded from LG or MG nerve after stimulation of the other muscle nerve varied with phase of stepping but did not parallel the variations of the MSR measured as EMG amplitude in the same muscle. The nerve responses were largest during the flexion phase of the step cycle and had a calculated central latency of 0.6-1.0 ms. These are interpreted as arising from antidromic activity in large-caliber afferent nerve fibers (i.e., dorsal root reflexes). 5. Spontaneous antidromic activity in severed L7 dorsal rootlet fibers to triceps surae was observed in the thalamic cats during episodes of locomotion and was closely correlated with flexion phase EMG activity in semitendinosus, a bifunctional muscle. 6. In decerebrate cats, dorsal root reflexes (DRRs) in severed filaments of L4-L7 dorsal roots were produced by stimulation of saphenous and posterior tibial nerves. These DRRs were always smaller during locomotion than during rest and were smallest during the flexion phase. 7. The short-latency antidromic activity produced in muscle nerves by stimulating heteronymous muscle nerves thus appears to be a DRR produced in Group I terminal arborizations that are depolarized close to threshold during the flexion phase. Such PAD could account for changes in the MSR that do not always parallel the levels of recruitment of the motor pools as manifest by background EMG amplitude.

Spinal Cord Circuits

Over the past decade, research at three different levels of sensorimotor control has revealed a degree of complexity that challenges traditional hypotheses regarding servocontrol of individual muscles: (a) The connectivity of spinal circuits is much more divergent and convergent than expected. (b) The normal and reflex-induced recruitment of individual muscles and compartments of muscles is more finely controlled than was noted previously. (c) The mechanical interactions among linked skeletal segments and their often multiarticular muscles are neither simple nor intuitively obvious. We have developed a mathematical model of the cat hind limb that permits us to examine the influence of individual muscles on posture and gait. We have used linear quadratic control theory to predict the optimal distribution of feedback from a hypothetical set of proprioceptors, given different assumptions about the behavioral goals of the animal. The changes in these predictions that result from changes in the structure and control objectives of the model may provide insights into the functions actually performed by the various circuits in the spinal cord.

Conduction studies in peripheral cat nerve using implanted electrodes: III. The effects of prolonged constriction on the distal nerve segment

Electrophysiological properties were monitored in detail in chronically constricted peripheral nerves by implanted, multicontact nerve cuff electrodes and correlated with morphometric histology in selected cases. The physiological and histological responses in nerve to a range of constricting cuffs of standard sizes were readily graded. The initial response to any significant constriction was a transient, focal conduction slowing or block at the constriction, followed by more protracted distal effects; the latter ranged from loss of excitability consistent with "dying-back" degeneration to reductions in conduction velocity consistent with histologically observed atrophy. Smaller myelinated fibers tended to have similar but less pronounced changes than larger diameter fibers. Recordings from ventral and dorsal roots showed that distal degeneration was more pronounced in motor than in sensory fibers of similar caliber. Electronmicroscopical measurements showed that basal laminas were relatively preserved around even the most atrophic and demyelinated axons. Perimeter measurements of the basal lamina could be used to estimate the diameter of the original nerve fiber.

Neural prosthetic interfaces with the nervous system

Once damaged, the adult mammalian nervous system is capable of little functional regeneration. Thus, clinical disorders such as deafness, blindness and paralysis have been treated primarily by substitution rather than correction (e.g. teletype for telephone, braille for print, wheelchair instead of walking). However, recent advances in the technology of miniature electronic implants and in the basic understanding of sensory and motor functions have made it possible to build neural prosthetic devices that work by exchanging information directly between computing devices and neurons. Such interfaces are already permitting thousands of otherwise deaf patients to hear sounds directly; some have appreciable speech comprehension without visual cues. There is active research on restoring many types of sensory, motor and autonomic function. Two interesting synergies have emerged. The first stems from the recognition that the biophysical processes involved in stimulating and recording from neurons are universal; thus, technical advances have broad implications in many clinical areas. The second stems from the unique opportunity that such prostheses present to conduct neurophysiological and psychophysical studies directly in conscious human subjects.